Ruan Pietersen, Author at Birnam Veterinary Clinic

Rabies

Towards the end of June 2021, the Gauteng Department of Agriculture and Rural Development (GDARD) informed the public of an outbreak of Rabies in the Cradle of Humankind area. Near the end of August 2021, the Western Cape government issued a warning of a new rabies outbreak and encouraged pet owners to ensure their pets' rabies shots are up to date. In early August, three women were attacked by a honey badger and tested positive for rabies, while earlier in September, a young boy in the Eastern Cape died from rabies as the result of a dog bite. Traditionally, rabies was considered to be restricted to Kwa-Zulu Natal and KZN was declared an endemic area for rabies. Unfortunately, it is no longer the case and the whole of South Africa is now considered endemic.

World Rabies Day on 28 September 2021 is an international effort to raise awareness about this terrible, yet totally preventable disease.

What is rabies?

Rabies is a zoonotic disease (passed from animals to humans) caused by infection by the lyssavirus, which attacks the nervous system of humans and other mammals like dogs and cats. It causes a range of symptoms and culminates in brain inflammation and ultimately death. Rabies kills around 55 – 60 000 people globally every year, with about 99,5% of those deaths resulting from dog bites. Rabies in pets is caused by the infectious saliva of a rabid animal entering the bloodstream of another animal due to a bite, scratch or lick. Rabies is incurable, so vaccination against rabies and keeping healthy pets away from infected animals are the only preventative measures against this disease.

How do pets get rabies?

Rabies is present in many wild animals – from rodents and bats to rabbits, meerkats, monkeys (less commonly) and honey badgers – and when pets have altercations with wild animals, they can contract rabies in the process. Pets whose rabies vaccinations are up to date can survive the infection, which is why it's so important to follow the vet's advice when they send reminders and to ensure all pets are vaccinated.

How will I know if my pet has rabies?

The signs of rabies infection include behavioural and physiological symptoms.

Behavioural symptoms:

sudden change in behaviour from the norm
aggression or viciousness
uncharacteristic affection in a normally withdrawn animal
fear of water

Physiological symptoms:

lethargy
fever
vomiting
motor/movement difficulty
loss of appetite
difficulty swallowing
difficulty breathing
excessive salivation or drooling
seizures
staggering
paralysis

When a usually calm animal suddenly starts displaying aggression, this is called 'furious rabies'. The animal may become easily agitated and may also show signs of an insatiable appetite, eating stones, dirt and anything it can find. As these symptoms progress, the animal eventually becomes paralysed and is unable to eat or drink. It may then have seizures that result in death.

In dogs, the most common sign of rabies comprises symptoms of 'dumb rabies'. The dog's face may look distorted, their walking pattern will look uncoordinated and their limbs could become progressively paralysed. They may show difficulty swallowing and as these symptoms progress, the animal is likely to slip into a coma and die. These final stages may resemble a long, drawn-out choking episode, so absolute care must be taken in examining or touching the dog, as the saliva may still be infectious.

How long will it take before my pet shows symptoms of rabies?

The rabies virus may incubate anywhere from three to 12 weeks before symptoms start to show. Sometimes symptoms develop in a much shorter or much longer period of time, depending on where on the body the bite occurred and how much of the virus entered the bloodstream. However, at the onset of symptoms, it's important to note that rabies is not treatable and will be fatal. This is why it's crucial to keep pets vaccinated against rabies and to get them treated for animal bites or any skin lesions as soon as possible and not wait until the symptoms show up.

What should I do if I suspect my pet has rabies?

If your pet has been in a fight with a stray animal (domesticated or wild), take note of the type of animal it was if you happened to see the fight and make sure you can give your vet all the details of the animal. Clean the wound with soap and running water for 10 minutes and then get your pet to the vet as quickly as possible.

How will the vet diagnose rabies?

In an ideal situation, the vet would need to observe the animal that bit your pet to determine how likely it is that it (and subsequently your pet) has rabies. Unfortunately, the only way to confirm the presence of rabies is to do a post-mortem test on the brain. The vet will ask whether you observed the animal that bit your pet and what kind of behaviour you noticed. In many instances, pet owners don't see the biting animal and only notice their pet having been injured. In this case, if the vet suspects rabies, your pet will receive a rabies booster injection and be quarantined and observed for any symptoms of rabies that may begin to show. In a case where there is a strong suspicion that your animal was bitten by an animal with Rabies and your animal is exhibiting all the signs and symptoms of rabies, legislation determines that the State Veterinary may have the obligation to insist that your animal be put to sleep (euthanised). Nobody would like that and therefore vaccinations are so critically important.

What will the vet do if my pet has rabies?

If your pet's rabies vaccinations are up to date, they have the strongest defence against contracting rabies from an infected animal. If a pet dog or cat's rabies shots are not up to date and their last vaccination was more than three years ago, they are likely to contract rabies from a rabid animal. If the vet diagnoses rabies from visible symptoms, the most humane thing to do would be to euthanise the pet, since there is no cure for rabies once the symptoms begin to show. In a case where there is a strong suspicion that your animal was bitten by an animal with Rabies and your animal is exhibiting all the signs and symptoms of rabies, legislation determines that the State Veterinary Service may insist that your animal be put to sleep (euthanised). Nobody would like that and therefore vaccinations are so critically important.

Can rabies be treated?

Unfortunately not. The best course of action against rabies is prevention.

How can I prevent my pet/s from getting rabies?

Keep each of your pet's rabies vaccinations up to date. Make sure you have an up-to-date record of these vaccinations in a vet card. If you cannot provide evidence of this during a rabies outbreak, you run the risk of your pet needing to be euthanised to keep other animals safe.
Keep your pets away from wild animals and stray dogs and cats. Always know where your pets are and ensure they do not antagonise wild animals. If you know of any stray dogs and cats in your area, contact your local SPCA or rescue organisation to ensure they can be removed.
Ensure your home does not attract pests. Do not leave pet food out in the open and make sure any home composting does not attract rodents, stray cats and other small mammals. If you suspect you may be harbouring bats in your roof, it's time to make an appointment with the relevant pest control company and get them removed.
Ensure your livestock are vaccinated. Livestock and other animals should also be vaccinated against rabies, especially if your pets have close contact with them.
Share this information with friends and family – their pets deserve protection too!

If you have any concerns about rabies or questions about the rabies vaccination protocol, speak to the vet and make sure your pet/s are protected against rabies.

Domestic pet poisoning

Poisoning is a common occurrence in domestic animals like dogs and cats. The most widely observed route of poisoning is via the mouth (orally), but topical poisoning and other routes of intoxication are also possible. No matter the route of poisoning, it’s critical to treat each individual case of poisoning as a matter of urgency, as some poisons could be life-threatening for the pet. In this article, we give an overview of the most commonly encountered poisons in private practice in this part of the world.

What is poisoning?

For our purposes, poisoning is defined as any substance that is ingested or absorbed via the skin, which causes harmful effects in a dog or cat. The substances that are poisonous to pets can range from regular human medications (over the counter, prescription and/or vitamins); human food that is not supposed to be fed to animals such as chocolates or grapes; pesticides; plants; or topical tick and flea treatment that is incorrectly used on the wrong species of pet.

How will I know if my pet has been poisoned?

There is often a rapid onset of the effects of poisons when the toxic dosage has been met – i.e. it will show quickly when your pet has ingested something poisonous. An exception to this is warfarin, which is used in rat poisons. This is a slow-acting poison that, if ingested by your pet, will only show symptoms up to a week or more later. In poisoning cases that are brought to the vet, pet owners usually report a sudden onset of symptoms, presence of the suspected poison in the home environment, rumours of recent malicious activity in the neighbourhood and, most importantly, definite reports of confirmed exposure to the poison; for example, seeing the animal eating the poison.

Common symptoms of poisoning

Signs of poisoning differ between the affected systems. Common symptoms of poisoning include excessive salivation, foaming at the mouth, vomiting, diarrhoea, muscle tremors and/or seizures, as well as abnormal bleeding. At other times the pet might show non-specific signs. However, as mentioned before, a suspicion of poisoning can be made given the sudden onset of the signs fitting poisoning.

Different types of poisoning

Rat poisons

Rat poisons are the most common poisons encountered in practice. Rat poisoning cases can be both as a result of accidental consumption in the home or when visiting neighbours and family, or malicious activity. There are two main types of rat poisoning: a slow-acting poison that affects blood clotting and a fast-acting poison that affects the nervous system as well as exerting effects on the digestive tract. Both types of poisons can prove to be fatal if the specific antidote is not given in time.

RATTEX (warfarin/coumarin) is an example of a poison that affects blood clotting. Usually, if the pet is not seen consuming this type of poison, symptoms will begin to show after a week. The pet can be lethargic and anaemic, as well as have abnormal bleeding. Blood tests are usually performed as part of the diagnosis and treatment monitoring. In general, pets begin to show signs of improvement once the specific antidote is started. Treatment can continue for up to three weeks depending on each case.

Organophosphate and ‘two-step’ poison are examples of poisons that affect the nervous system. These poisons are highly potent and fast-acting. In cases of malicious poisoning, with high dosages of poison being delivered in food, the pet is usually found dead within an hour of ingesting laced food. There is an antidote for this poison, which is beneficial when administered in time. In-hospital care is required for this type of poisoning.

Human medicines

What is very good for the pet owner is often not the best thing for the pets. Human medicines are notorious in animal poisoning cases. They are easily accessible to pets, which means they become common causes of poisoning in animals. Human medicines that can be harmful to pets include painkillers, vitamins and supplements. They can result in kidney injury, gastric ulceration, bone marrow suppression, cardiac function depression, and sometimes, particularly in female unsprayed dogs, female reproductive problems. Given the vastness of the potential effects of human medicines, symptoms are quite diverse and will depend on the specific medication consumed. To further complicate the situation, some effects are not seen immediately and can possibly take a couple of months before being evident. This means the connection between the pet’s symptoms and the consumption of human medicine might be missed.

Human food

Human food consumed by dogs and cats can also cause pet poisoning. Grapes, chocolate, xylitol, alcohol and macadamia nuts are notorious for poisoning pets. Several other products can also cause poisoning in animals; lists of which are found on the national poison database. Again, depending on the food product consumed, signs of food toxicity can range from diarrhoea, vomiting and nausea, to hyperactivity, tremors, seizures, hypoglycaemia, renal failure and/or death. In general, the vet can induce vomiting if the pet consumed the toxic food less than two hours prior.

Plant poisoning

Different types of toxic plants exist in our home environments. Toxic plants can include flowers or other ornamental shrubs and trees. These plants can cause various detrimental effects in our pets, ranging from localised mouth and tongue reactions, liver damage and liver failure, kidney injury and/or failure, and heart failure. Plant poisoning in dogs and cats can prove to be extremely difficult to diagnose in practice unless the pet owner mentions clues when speaking to the vet. Diagnostic tests can make the case work-up easier and provide a better outcome for the pet. Since there are no antidotes to plant poisonings, pets will be treated for their symptoms and their health managed accordingly.

The elephant leaf garden plant is an example of a plant poison that causes localised irritation and swelling in the mouth and tongue. This type of poisoning is often seen in puppies who will chew at everything they can get to out of curiosity. Treatment is mainly targeted at managing the symptoms and often carries a good prognosis.

Cycad seeds are notorious for causing liver problems in dogs. Usually, pets are presented to the vet showing gastrointestinal signs such as vomiting, increased thirst and profuse salivation. Bloodwork will show evidence of liver disease. In other instances, symptoms are non-specific until a diagnosis is reached following a thorough history-taking and relevant blood test results.

What to do if your pet is poisoned

Simple: take your pet to the vet! If you cannot get to the vet’s office immediately, phone in and ask for advice.

If you have just witnessed your pet consuming poison (within the last two hours or less), quickly get your pet to the vet to induce vomiting – if applicable. In the case of anticoagulant poisons like warfarin, it’s neither wise nor helpful to induce vomiting, as ingestion and digestion would have occurred days before. Depending on the oral poison ingested, it can sometimes be helpful to give your pet activated charcoal to reduce the amount of poison being absorbed. If your pet has just been exposed to a topical poison, the best would be to wash the area on the skin to decontaminate it and reduce the amount of poison being absorbed. Thereafter, rush your pet in for emergency care at the veterinary hospital.

If your pet is experiencing seizures, it is important to protect them from inadvertently injuring themselves. Keep them in a padded area that is free of sharp protruding objects.

If you know which poison your pet has ingested, take the packaging with you, as this will be useful to the vet. It will save a lot of time unnecessarily searching for diagnostic clues and researching other symptoms and effects to anticipate.

Case management at the veterinarian

A case of poisoning is always addressed as an emergency until an antidote is given and the pet patient is stable. Following the collection of a relevant, brief and concise case history by the vet, any of three main routes might be elected. These include:

Inducing vomiting and stomach washing
Giving the antidote if available, and
Case workup to identify exact systems affected and hopefully the exact cause of poisoning.

Once a diagnosis is reached, treatment is given along with the necessary case monitoring. Patient follow-ups are also very important, and this is where adhering to the vet’s recommendations will be beneficial to the pet.

Prognosis

Prognosis with poisoning cases is case dependent. However, factors that could improve the prognosis of each case include early diagnosis and intervention, the availability (and timely use) of an antidote, and the proper post-treatment follow-up. When dealing with poisons without antidotes, a good response to treatment without permanent vital organ damage usually carries a good prognosis. Prognosis is therefore poor when there is no (or delayed) intervention, as well as damage to vital organs, which could prove detrimental.

As a pet owner, you are encouraged to be vigilant about your pet’s access to potentially poisonous materials. Should they end up in the unfortunate position of being accidentally poisoned, do not rely on home remedies to treat your pet – rather get them to the vet as soon as possible.

Corneal Ulceration

My pet’s eye is half-closed and there seems to be something in their eye

What is a corneal ulcer?

A corneal ulcer is damage to the corneal surface, which is the thin, clear covering of the eye. The cornea is made up of three layers: the outer epithelium, the stroma (which is thickest and acts as the scaffold) and the Descemet membrane. All three layers are transparent, allowing light to enter the pupil and create an image that our brain interprets as the sights we see around us.

https://www.allaboutvision.com/resources/cornea.htm

How does a corneal ulcer occur?

The most common cause of an ulcer on the cornea is due to trauma. Damage may occur from a sharp object like a cat scratch or from your pet rubbing their eye on a rough surface. Damage can also occur from chemical irritation like getting shampoo in the eye or even if something rough gets caught under the eyelid, scratching the eye every time they blink.

Infections from viruses or bacteria can also lead to corneal ulceration. There are some systemic diseases that can lead to corneal ulcers such as diabetes mellitus, Cushing’s disease or low thyroid hormone levels (hypothyroidism).

Corneal ulcers can also occur due to lack of sufficient lubrication of the eye. This is a medical condition called keratoconjunctivitis sicca (KCS), commonly known as ‘dry eye’.

Some breeds such as the boxer can inherit a degenerative condition called epithelial dystrophy. Epithelial dystrophy causes a weakening of the outermost surface (epithelial layer) of the cornea, easily leading to corneal ulceration.

How bad is a corneal ulcer?

Damage to the cornea is characterised into three parts depending on the depth and severity of the injury.

The superficial injury to the outermost surface (epithelium) is called a corneal abrasion or erosion.

Damage that extends past the epithelium into the stromal layer is termed a corneal ulcer.

Injury that extends through the stroma and affects the final layer of Descemet membrane is called a Descemetocele. If this final layer is damaged and the outer surface of the cornea is ruptured, the globe of the eye will lose its structure the animal will lose their eye.

How do I know if my pet has a corneal ulcer?

Corneal ulcers are painful. If a pet has a corneal ulcer, they will usually keep their eye tightly closed, often tearing excessively and often pawing/rubbing at their eye. When the eye is opened, the white of the eye (the sclera) is often red and the area around the eye known as the conjunctiva may be pink due to the irritation and may be swollen. In the cases of large ulcers a depression or even a crater-like cavity can be seen on the surface of the eye. The outer edges of the ulcer absorb moisture from the tears and can appear cloudy or even white. This change is called corneal oedema and is sometimes the only sign that there has been damage to the surface of the eye.

Can a corneal ulcer be treated?

Yes. Corneal ulcers should be treated, even if they appear small and insignificant. Once the outer epithelium of the eye has been damaged, bacteria often take advantage of the opening and can start colonising the now vulnerable second or stromal layer. Once bacteria have a foothold they cause the ulcer to degenerate and enlarge, potentially to the point of loss of the eye. Corneal ulcers are not to be scoffed at.

What will the vet do if my pet has a corneal ulcer?

When the vet examines your pet’s eye they will use a fluorescein dye that will cause a colour change to show the presence of damage to the cornea. With a special ophthalmic light, this allows the vet to visualise the extent of the damage and also monitor the ulcer size once treatment has begun.

Corneal ulcers are usually treated with antibiotic eye drops and the vet may also prescribe eye drops or oral medication for pain. The vet may also include anti-inflammatory eye drops to reduce the swelling and inflammation in and around the eye. There are some eye drops for animals that contain cortisone, which should never be used when an animal has corneal ulceration. It is really important that you don’t just get drops from a friend whose animal had an eye condition and start putting that your animal’s eyes. Similarly, you should also not use just any human eye drops, as this medication may be contra-indicated. In South Africa, as a result of the pet population being significantly smaller than the USA or European markets, some pharmaceutical companies do not register their products here. This means that in some instances, the vet may have to rely on a human medication. This is called extra label use, and the vet will take care to use a product that is compatible with your pet.

Antibiotic eye drops are only active for a few hours and as such need to be applied often. Depending on the severity of the ulcer, this can be from every hour to every four hours. Other eye drops, such as Atropine eye drops are active for much longer and usually only need to be applied once or twice a day. The vet will give you proper instructions as to how often to use the medicine prescribed.

It is important to continue treatment as per the veterinarian’s recommendations and not discontinue treatment too early, even if you see improvement. Speak to the vet if you are unsure.

The vet will most likely demonstrate to you how to apply the eye drops during the consultation for the eye problem and ensure you are comfortable applying them yourself before you go home.

The vet may advise on the use of an Elizabethan collar, known as the ‘cone of shame’, to prevent your pet from scratching and doing more damage to an already injured eye. This prevents paws and sharp nails from reaching the eye and is recommended until treatment is complete or the pain is under control.

Will my pet need another visit after treatment has started?

Yes, most vets require a check-up one week after treatment is started unless an earlier one is needed. This is to re-stain the eye to monitor the progress of healing. Pet owners must keep a close eye on injured eyes. If your pet’s eye seems more painful or if a pus-like discharge develops, rather see the vet sooner.

Most ulcers and erosions heal quickly while others require a bit more time. If there is minimal improvement after two weeks, the vet may advise on additional treatments or surgery. Depending on the case, you may be referred to a veterinary eye specialist.

Can eye drops have negative side effects?

There may be negative side effects, but this occurs rarely. If your pet is sensitive to an ingredient in the eye drops, you may see a marked response of swelling and irritation around the eye. If your pet’s eye appears more angry and painful after the eye drops than before, stop using them and speak to your veterinarian about an alternative.

Atropine eye drops if prescribed will cause the pupil to dilate in the eye in which it is applied. This is a normal and expected response. This also means that the eye is more sensitive to light and your pet may squint when in bright light.

You may notice that your pet salivates a bit more after application of eye drops, especially cats. This is because eye drops are bitter and may drain into the sinuses and sometimes into the back of the throat. This is not an allergic reaction, but rather the response to tasting the bitter eye drops.

If ever your pet keeps their eyes half or totally closed when not sleeping, get them to the vet sooner rather than later as a deep corneal ulcer can destroy the eye.

References:

Corneal Ulcers in Dogs by Ernest Ward, DVM, https://vcahospitals.com/know-your-pet/corneal-ulcers-in-dogs. Viewed on 29 September 2020.

Corneal Ulcers and Erosions in Dogs and Cats by Wendy Brooks, DVM, DABVP, reviewed 10 Oct 2018, https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951434 viewed on 29 September 2020.

Acute Abdomen

Now and again pet owners are faced with emergency situations when their pets are suddenly in severe belly pain. Unexpectedly, both the owner and the pet are in a moment of anxiety and distress. So what could possibly be going on? This sudden severe belly pain is what veterinarians call an acute abdomen.

What is acute abdomen?

Acute means to happen suddenly, while the abdomen is the lower part of the trunk of the body, often referred to as the belly. The term acute abdomen refers to sudden pain in the belly. This sudden, severe pain in an animal’s belly should be treated as an emergency and requires immediate evaluation and response by the vet.

Pet owners will often report that their dog or cat was fine yesterday or earlier in the day before showing the sudden signs of terrible belly pain. The pain could arise from any of the following:

gastrointestinal tract (GIT) and inner lining of the abdominal body wall
other organs in the abdominal cavity (liver, pancreas, spleen, kidneys, reproductive tract, lymph nodes, diaphragm)
muscle and skin around the abdominal cavity
emanating from other systems outside the abdominal area such as back pain.

Acute abdomen can be life-threatening and should be considered an emergency.

What will I see if my pet has an acute abdomen?

Since there are so many possible causes of acute abdomen, it is not surprising that its symptoms will be equally diverse. Further complicating the situation is the fact that the symptoms may be non-specific to any one particular cause. So, how can a pet owner judge from home that their pet is in a crisis situation? To help pet owners reach the decision to take their pet to the vet for examination, below is a summary of possible symptoms of acute abdomen.

Pet owners should look out for:

restlessness
unusual panting
arching of the back
body posture changes such as assuming the praying position (with their front legs on the ground and their rear end in the air)
retching or trying to vomit without success
loss of appetite
marked sensitivity when owners attempt to stroke their pets in the belly area
distention of the belly such as with advanced pregnancy, or when there is a marked accumulation of fluids in the abdominal cavity

With very painful conditions or when shock sets in, the respiratory rate and heart rate might be elevated and there may be a loss of colour in the mucous membranes.

What can cause an acute abdomen?

Acute abdomen can be caused by problems in any of the various systems located inside and/or (less frequently) outside the abdominal cavity. Potential causes of the syndrome range from injury, infection, swelling or inflammation, blockages in organ systems, to cancer.

Trauma

The pet owner may have missed potential injury or incidents of trauma. Forces from a kick, bump or a fall can lead to organs shifting to unusual positions in the body, which would normally be impossible for a pet owner to realise. These incidents can cause excruciating pain. Examples of this include diaphragmatic hernias, where internal organs punch up into the chest cavity and cannot slip back out. This is commonly seen when a pet is bumped by a car.

GIT obstruction

Pain in the belly can also originate from the GIT. Blockages in the stomach or intestines can be caused when objects such as toys or bones are swallowed whole. Pain and injury to these organs can occur when the stomach or intestines twist around themselves or even ‘telescope’. Other organs such as the spleen can also twist in association with the stomach torsion – another emergency and cause of acute abdomen in itself.

Inflammation/Disease

Life-threatening inflammatory conditions affecting the liver or pancreas are also frequently seen as causes of acute abdomen. Pancreatitis or liver disease (abscesses or cancer, as examples) are also a common cause of acute abdomen.

Examples of other possible causes of this syndrome include peritonitis, stomach ulcers, kidney disease and infections and cancer of the reproductive tract – in both male and female patients. Disc disease (back pain) is an example of pain outside the abdomen that can present as acute abdomen.

What should I do if I suspect my pet has an acute abdomen?

Severe belly pain should be treated as a medical emergency. Take your pet to the nearest vet ASAP. Any delay can have fatal consequences.

What can I expect when I get to the vet?

Sequence of events at the veterinary hospital:

Upon arrival at the veterinary hospital, the patient will be attended to as an emergency in line with the pet owner’s complaint. The vet will then seek to confirm if the symptoms are truly suggestive of acute abdomen.

To confirm the vet’s speculation of acute abdomen, the pet owner would need to give an accurate and detailed history of the pet’s condition and lifestyle. The vet will ask many in-depth questions to get a better idea of the pet’s medical history and what might be causing their discomfort. Information will be requested regarding the names of current medications the pet is receiving, recent abdominal surgery the pet would have undergone, time estimate of when they noticed signs of pain or distress as well as the progression of the symptoms. As much as it might feel like an interrogation by the vet, this detailed information assists in speeding up the process of providing the best care for the pet.

Depending on initial findings by the vet, some pets would require stabilisation before he can do a more thorough physical examination. Once this examination is completed, a diagnostic workup plan is designed by the vet and discussed with the owner. The findings from the diagnostic tests performed will inform the staff on how best to care for the pet patient. The best care for the patient with acute abdomen can only be achieved through in-hospital care for a couple of days.

Which steps will my veterinarian take in order to find the problem?

Acute abdomen affects other body systems apart from the gut. Systems that put the patient’s life at risk that are commonly affected are the cardiovascular system, respiratory system, central nervous system, renal (kidney) system and the hepatic (liver) system. Blood tests will assist in providing an overview of the state of health of most systems. Imaging (x-ray and ultrasound scan) of the abdomen and chest areas also forms part of the diagnostic tests.

Depending on what is found on these tests, the vet may recommend surgical intervention. This may include an exploratory laparascopy where all the organs can be visualised and surgically corrected where appropriate. A host of other tests might be ordered if deemed necessary for the survival of the patient. Some tests might be repeated in the days to follow as part of monitoring the patient’s response to treatment.

How is acute abdomen treated?

A good diagnostic workup informs the decision on how to treat or manage the case. Having a diagnosis helps to categorise whether the case will be managed medically, as a surgical emergency, or as a delayed surgical case requiring the patient to be stabilised before undergoing surgery. Fluid replacement in the form of a drip is generally advocated in all cases of acute abdomen as it aids in supporting the heart and blood pressure. Medical management entails the use of appropriate drugs to relieve the patient from pain, treat infections, and addressing other possible symptoms such as stopping vomiting and diarrhoea. Surgery is reserved for cases that require surgical intervention for survival.

Conclusion

Acute abdomen is a medical and/or surgical emergency in which time is of the essence. Early intervention improves the chances of the pet’s survival. Unfortunately, due to the broad possible causes of presenting signs, proper management of each case relies heavily on a thorough diagnostic workup. Good pet owner cooperation with the veterinary teams at the hospital is of paramount importance, and dare I say, could be the difference between life and death.

My pet has put on weight and is acting slow and lazy. His hair is falling out and he has recurring skin infections. He also seems cold all the time. What’s going on?!

What is hypothyroidism?

As with humans, hypothyroidism is caused by low levels of thyroid hormone being produced by the thyroid gland, which is located on either side of the throat. Since the thyroid gland is part of the endocrine system, any decrease in thyroid hormone secretion has an effect on multiple systems in the body that rely on hormones to function properly – like the metabolism.

What are the symptoms?

There are many different symptoms of hypothyroidism because thyroid hormones affect so many different parts of the body. Deterioration of the thyroid gland and its functioning are gradual and progressive, so the onset of symptoms may not be immediately noticeable. If your pet is displaying any or all of these symptoms, they could be linked to hypothyroidism:

lethargy, inactivity or laziness
weight gain
mental dullness
hair loss/excessive shedding/thinning of the coat
dry and lustreless coat
excessive scaling of the skin
recurring skin infections
hyperpigmentation (skin darkening)
ear infections
cold intolerance (manifests as heat-seeking behaviour)

Sometimes hypothyroidism can also be associated with any of the following: generalised weakness, incoordination, head tilt, facial paralysis, seizures and infertility.

Which pets are more likely to be affected by hypothyroidism?

Hypothyroidism in cats is rare and is usually caused when the thyroid gland is removed or by the over-treatment of hyperthyroidism.

Hypothyroidism is common in medium to large breed dogs, with the average age of diagnosis being between the ages of four and 10 years old. Some breeds are more predisposed to developing hypothyroidism, such as golden retrievers, Doberman pinschers, Irish setters, Great Danes, Airedale terriers, dachshunds, Old English sheepdogs, miniature and giant schnauzers, cocker spaniels, poodles and boxers. Sterilised dogs have a higher risk of developing hypothyroidism, but vets are unsure why this is the case – it certainly is not a reason to not sterilise your pet!

What causes hypothyroidism?

Approximately 95% of hypothyroidism in dogs is caused by outside factors that have a negative influence on the thyroid. Very rarely are animals born with a faulty thyroid; similarly, it’s also rare for hypothyroidism to be the result of thyroid cancer. Many cases of hypothyroidism are ‘immune-mediated’ or caused by the immune system attacking the thyroid gland (lymphocytic thyroiditis), while in other cases, thyroid tissue is replaced by fat tissue (idiopathic thyroid atrophy).

Secondary acquired hypothyroidism, which is also rare, is caused by a dysfunction of the pituitary gland, which secretes thyroid stimulating hormone (TSH) and affects how the thyroid gland produces thyroid hormones.

What will my vet look for if hypothyroidism is suspected?

Hypothyroidism influences several body systems including the metabolic, skin, behavioural, neuromuscular, reproductive, gastrointestinal, ophthalmic, cardiovascular, and nervous systems. The vet will thus need to piece together a rather complicated puzzle made up of the pet’s history, the symptoms they are showing, the vet’s own examination and blood tests. To rule out thyroid tumours, the vet may take an X-ray. The blood tests will reveal low thyroid hormones in the blood, non-regenerative anaemia, and sometimes high levels of TSH. Most dogs with hypothyroidism will also have high levels of cholesterol, while half will have anaemia.

The vet will also look for thickening of the skin, which – when it occurs around the face – causes a sagging face and a sad or ‘tragic’ expression.

Can hypothyroidism be treated?

Unfortunately, hypothyroidism is an endocrine condition, which cannot be cured – it can only be managed, which must go hand-in-hand with a good quality of life for the affected pet. Managing hypothyroidism successfully relies on care in these four pivotal areas:

i. Diet

The pet’s diet must be properly managed to lower their weight until they reach a good body weight and thyroid hormone levels reach the normal range. Different pets will have different dietary needs, which is why it’s important to follow the vet’s recommendations and to give the affected pet a prescription diet to help with weight management.

ii. Client education

Pet owner education is critical in successfully managing hypothyroidism. You as the pet owner have to understand that treatment will be life-long, which means additional commitment to your pet for the rest of their life. When treatment begins, some symptoms may worsen before they improve, and may take between a few weeks to a few months to resolve, but don’t panic and please be patient. It’s important to stick to the recommended treatment as it will help in the long run. Abandoning the treatment prematurely will further reduce your pet’s quality of life.

iii. Drugs

The use of medication is the easiest part in the treatment of hypothyroidism. The prescribed medication includes thyroid hormone substitutes. They need to be given daily for the rest of your pet’s life, at the vet’s recommended dosage. Any additional drugs would be used to manage any of the other symptoms, such as controlling skin infections.

iv. Follow-up

Since hypothyroidism needs life-long management, routine follow-ups will be necessary, if not mandatory. Expect frequent follow-ups in the early stages of treatment, but as your pet’s symptoms begin to respond positively to treatment, these vet visits will become less frequent. In future follow-ups, the vet will examine the symptoms and perform blood tests to see how your pet’s hormone levels are responding, then adjust the medication and other therapies accordingly.

Conclusion

It may be stressful to see pets suffering from the symptoms of hypothyroidism, but once diagnosed, this condition is not a death sentence. It requires your commitment to proper treatment and giving your pet a great quality of life, all with the help of the vet and keeping them up to speed with your pet’s progress.

Is my dog ill?

Thanks to the nationwide lockdown, we’ll all be spending the next three weeks in the constant company of our furry friends. As the days go by, you may notice some behaviours or signs in your dog that you haven’t noticed before and may wonder if these are cause for concern. This article will outline the most common signs of illness that you may notice in your dog.

Changes in appetite or drinking habits

You may notice a sudden decrease or increase in your dog’s appetite. He may eat less than usual, take longer to finish his meals or even refuse to eat at all. You will easily notice any changes if you feed your dog set meals. However, if he is used to having food out all the time or you have more than one pet in your household, it may be trickier. Pay attention to how frequently you have to refill the food bowls – if it suddenly becomes more or less frequent than usual it may mean that something’s up.

Also make sure that the food bowls are kept out of reach of pigeons and birds – given the chance, they may eat all of your dog’s food and lead you to believe that your dog is eating well when he actually isn’t.

Similarly, your dog may start drinking more or less water than usual. If he starts drinking less than usual he’s at risk of dehydrating. A vet visit will help to determine why he’s refusing to drink and also address any dehydration that may have occurred. If your dog is drinking more water than usual it may also indicate an underlying issue that needs to be addressed, especially if it’s accompanied by more frequent urination.

Lethargy

Another common sign of illness is lethargy – your dog may seem to have less energy than usual and spend more time sleeping or simply lounging around.

Changes in toileting habits

You or someone in your household will probably already have an idea of what toileting habits are normal for your pet. Diarrhoea in dogs occurs very commonly and has several causes, including a change in diet; chewing or eating something unusual, especially when digging into the garbage bin; parasites such as worms; stress and even organ issues. If your dog is constipated, he will pass small, hard stools infrequently or no stools at all. Phone the vet if you notice a change in the colour, consistency or frequency of your dog’s stool.

Similarly, you may notice a change in your dog’s urination habits. He may urinate more frequently than normal or your house-trained dog may suddenly start having ‘accidents’ in the house. Pay attention to how he urinates – is he straining or does the urine just dribble out? If it just dribbles out, is your dog awake/excited/asleep when it happens? Is he also drinking more water than normal? Is he showing any other signs of illness? The vet may ask for this information in order to guide them towards the correct diagnosis.

Repeated vomiting

Vomiting can be caused by a variety of conditions where the primary cause is not in the gastrointestinal tract as one would anticipate. As an example, kidney failure may cause an increase in the blood levels of by-products of protein synthesis, which can make your dog nauseated and cause him to vomit, with no inherent defect in the intestine. Puppies are sometimes prone to overeating or eating too fast, which may lead to vomiting. Dogs love chewing things, and foreign objects that have been swallowed and cause obstruction are a common cause of vomiting. Take your dog to the vet if you notice him vomiting repeatedly or more frequently than usual, and especially if the vomiting is accompanied by other signs of illness. Vomiting can be associated with many different underlying systemic diseases, and if gastrointestinal causes have been ruled out, further investigation will be required.

Blood in the urine, stools or vomit

Blood in any of your dog’s excretions is never normal and warrants investigation by the vet. Dark brown to black stools or vomit may indicate the presence of partially digested blood.

Unexplained weight gain or loss

If your dog suddenly starts losing weight it may indicate an underlying illness. It is also worth noting that weight loss may not always be accompanied by a loss of appetite. Take your dog to the vet if you notice he’s losing weight without a change in his diet or exercise patterns.

Conversely, weight gain can lead to obesity, which comes with its own set of health problems. The vet can help you determine why your dog is gaining weight and also help you come up with a plan to get him back to a healthy weight.

Changes in breathing

In dogs, panting is a normal process that aids in controlling their body temperature. Dogs can also pant due to stress or excitement. Hacking, coughing, sneezing, wheezing, shortness of breath and raspy breathing, however, are all abnormal and should be investigated by the vet.

Mobility issues

You may notice your dog limping, having difficulty getting up or seeming stiff and reluctant to play or go for walks. It is very important to note that just because a dog isn’t crying out, it doesn’t mean he’s not in pain. Dogs do not form an emotional connection to pain as we humans do; they simply accept the pain as their new reality and continue with their lives. Older dogs, like humans, are prone to developing arthritis, while younger dogs may be affected by any number of mobility issues. The vet will be able to diagnose your dog’s condition and recommend therapies to make him more comfortable.

Behavioural changes

Dogs are generally quite consistent with their behaviour, so if your friendly dog suddenly becomes grouchy, your boisterous dog suddenly becomes timid, your independent dog suddenly becomes needy and clingy, or your dog just seems ‘off colour’ it may mean there’s a problem. Also pay attention to how much your dog vocalises normally – if he suddenly starts crying, barking or moaning more than usual there might be a medical reason for it, which should be ruled out before deciding it’s a behavioural issue.

Dry, red or cloudy eyes or eye discharges

Dogs are susceptible to a variety of eye issues, which can be diagnosed and treated by your vet. If the eye is sore your dog will typically keep it closed most of the time and may even rub or scratch at it. If this is the case, take him to the vet sooner rather than later – he may have an ulcer in his eye, which, if neglected, can result in the loss of the eye.

Discharges from the nostrils

Excessive watery fluid, a yellow discharge or blood are never normal nasal discharges and warrant investigation by the vet. Either one or both nostrils may be affected and the discharge may sometimes be accompanied by sneezing. You may have heard rumours of a cold, wet nose indicating a healthy dog and a hot, dry nose indicating illness. There is unfortunately no evidence to support this idea and it is nothing more than an ‘old wives tale’.

Ear debris or discharge

Look out for a dark brown or yellow wax-like substance accumulating in or around the ear canal as well as redness or swelling of the ears. Your dog may also shake his ears or scratch at them constantly. If you notice these signs, your dog may have an ear infection or parasite infestation, which is very uncomfortable and sometimes even painful.

Skin irritation, hair loss or coat changes

Dogs are susceptible to a variety of skin conditions, which can be painful, itchy or otherwise uncomfortable. You may notice redness, scabs, bald patches, crusting, dandruff, pimples or even blackheads. Also look out for changes in his coat – a normal coat is smooth and glossy. Take your dog to the vet if his coat suddenly becomes dull and dry, greasy, smelly or if the coat seems to thin out.

Bad breath

Remember that a mild degree of ‘dog breath’ is normal for dogs. Severe bad breath, however, is not normal, especially if it’s accompanied by drooling and bleeding from the mouth. Also look out for swollen, red gums, brown to green calculus build-up on the teeth and even loose teeth. These all indicate gum disease, which, if left untreated, can cause difficulty eating due to pain as well as long-term health effects.

Swelling

Swelling anywhere on your dog’s body should not be ignored, especially if it’s hot or painful to touch. Dogs can develop abscesses from wounds as well as a wide variety of tumours. If your dog’s muzzle seems to swell up suddenly he may be having an allergic reaction to something. The vet will be able to determine what the swelling is and treat it accordingly.

Emergency situations

Some conditions need urgent attention and, if not addressed promptly, can be fatal. It’s always a good idea to keep the contact details of the vet’s after-hours telephone or of a 24-hour facility handy in case you ever need it. If you notice any of the below signs, rush your dog to the nearest open vet immediately.

Trauma, such as a dog fight, getting hit by a car, etc.

Blue, white or very pale gums

Difficulty breathing

Sudden inability to walk

Moderate to profuse bleeding

Seizures or tremors

Dizziness, disorientation, circling, head tilt or imbalance

Collapse, unconsciousness or unresponsiveness

Severe pain (crying out loudly or excessively or acting aggressive when touched)

Distended, bloated abdomen especially in large breed dogs

Rectal temperature above 39.5°C or under 36°C

If you notice anything about your dog’s appearance or behaviour that’s worrying you, it’s always better to rather be safe than sorry. Phone the vet so they can help you decide whether it’s an emergency or otherwise take your dog to the vet.

My cat’s eyes are swollen and teary

What is conjunctivitis?

Conjunctivitis is the inflammation of the conjunctiva. The conjunctiva is the thin semi-transparent mucous membrane lining the inside of the eyelids, covering the third eyelid. This membrane attaches to the globe of the eye at the level of the sclera (the white part of the eye). The back end of the word conjunctivitis (– itis) refers to inflammation which is a defense mechanism of the body and means swelling, redness, increased heat to the local area because of an increase in blood flow to the affected area, and pain or discomfort. Conjunctivitis is a very common condition affecting our household cats.

What causes conjunctivitis?

This condition is typically caused by infectious organisms such as viruses like Feline Herpes Virus or Feline rhinotracheitis virus or bacteria such as Chlamydophila Felis or Mycoplasma. Other causes can include trauma to the eye which most cats typically sustain through cat fights, immune-mediated conditions where the body overreacts to a stimulus and ends up causing more damage to itself, or sun damage especially in white cats with unpigmented eyelid margins. Infectious causes of conjunctivitis are the most common and are important to treat, but more importantly prevent, as the infection may spread from one cat to another. Infectious conjunctivitis is usually a condition affecting younger cats. Cats that may be at increased risk for infectious conjunctivitis include those that live in multi-cat households, cats taken to the kennels or a cattery, cats exposed to other sick animals at the vet, or free-roaming cats that come into contact with all the neighbourhood’s cats. Another risk factor for this condition is the presence of an underlying immunosuppressive condition such as FeLV (Feline leukemia virus) or FIV (Feline Aids) which predisposes affected cats to these infections due to their reduced ability to fight off infections.

Cancer of the conjunctiva more commonly affect older cats, typically cats with no pigment in their eyelid margins. Their eyelids are effectively sunburnt and the process starts off with inflammation of the eyelids causing conjunctivitis, and eventually progresses to full blown cancer. If sun exposure can be restricted or contained, this condition can be prevented.

What are the clinical symptoms of conjunctivitis?

Clinical signs may vary in degree and affect one or both eyes. Your cat may have painful red eyes, some discharge from the eye which may be either watery or pussy in later stages of the disease, and in severe cases the eye may even be closed due to excessive swelling of the conjunctiva. These signs may be recurrent and vary with severity during the course of the disease. With infectious causes such as viruses there are often signs and symptoms of other upper respiratory tract infections such as sneezing, discharge from the nose and a loss of appetite partly due to a loss of smell.

How is conjunctivitis diagnosed?

Conjunctivitis is diagnosed by the veterinarian carefully examining the eye and all its adjacent structures and looking at all the different parts of the eye. What vets often look for is the presence of red inflamed conjunctiva, discharge from the eyes, signs of trauma or potential causes of the inflammation. If a cat with conjunctivitis is presented to the vet, the vet may do certain tests to check other parts of the eye such as the cornea, tear duct function and even eyeball pressure. This is important to rule other eye conditions which also have conjunctivitis as a symptom, but requires a completely different approach to treatment. These tests include a fluorescein dye test, where a luminescent green dye is applied to check for any defects or ulcerations of the cornea (the glassy clear layer on the front of the eyeball through which the animal looks). Another test is the Schirmer tear test that checks the tear production and determines if your pet suffers from dry eye. Lastly, the vet may want to test the eye’s pressure to determine if glaucoma may be present. Glaucoma is a condition of increased pressure within the eyeball, causing gradual loss of sight. On some occasions, if treatment is not working, more in-depth procedures such as blood tests, biopsies and conjunctival samples for bacterial growth may be necessary to determine the underlying cause of the conjunctivitis.

How is conjunctivitis treated?

The treatment goals for any case of conjunctivitis in cats include treating the underlying cause, eliminating infection (if present/possible), and reducing pain and discomfort. If there is an underlying cause that has been identified, this will be treated. Generally the treatment entails eye drops that need to be given at home according to the vet’s instructions. On this note something many of us are guilty of is trying to self medicate our cats with human over the counter eye drops. This is not a good idea as some human medications are contra-indicated in cats and by using the wrong medication we can actually do harm and make the condition worse. Always seek the advice of the vet before applying any medication. This also applies to eye drops prescribed by the vet previously or to another animal in the house hold. If the eye medication contains cortisone and there is ulceration on the cornea, it will only worsen the ulcer and your animal may lose its eye.

What is the prognosis if my cat has conjunctivitis?

The prognosis of conjunctivitis is generally good but depending on the cause of the conjunctivitis, certain complications may arise. Infection with herpes virus may lead to a corneal sequestrum, symblepharon (partial or complete adhesion of the eyelid conjunctiva to the eyeball conjunctiva), or dry eye. These conditions are permanent and the cat will never recover fully if complications like these arise. Conjunctivitis may be recurrent or chronic in some cases of infections. Because cats with herpes virus are often chronic carriers it is important to reduce stress in the environment as that is often the trigger for recurrent infections. Cats with underlying Feline Leukemia Virus (FeLV) or Feline Aids Virus (FIV) cannot be cured and because of their compromised immune systems, will always be prone to complications. Because of the recurrent nature of conjunctivitis in certain cats please do not lose faith in the vet or his or her ability to treat your cat. Work with the vet to understand the specifics of your cat’s condition and if the condition cannot be cured with a once off treatment, work out a strategy with the vet to manage the condition as effectively as possible. As with all medical conditions in pets, the sooner you attend to the problem once you notice any symptoms of conjunctivitis in your cat, the higher the likelihood of success with treatment. Don’t leave it till the cat can hardly see from its eyes and only then try and do something about it.

Is there a way to prevent conjunctivitis in my cat?

The answer is an unequivocal YES! By far the most effective way to prevent your cat from getting conjunctivitis is to have it vaccinated at the correct intervals and with the correct vaccines to prevent the upper respiratory tract diseases collectively known as “Snuffles”. Is it fool proof and will vaccination definitely prevent your cat from contracting these diseases? The answer is no. Sometimes viruses mutate or different strains infect your animal to what was in the vaccine. Does this mean that vaccinating is “fighting a losing battle”? Not at all. Having your cat vaccinated is certainly the best way to prevent disease, but does not guarantee that they won’t get infected. Making plans with cats who roam and land up in fights is a tough task, but can be done when there is a will to do so. Keeping cats with unpigmented eyelids indoors and out of the sun, is also a tough task because cats are by nature so inquisitive. Yet, if is means a better quality of life, cancer free, it is a small price to pay. Discuss your cat’s particular circumstances with the vet and find a solution with professional help.

There is something wrong with my dog’s eyes

What is “dry eye?”

Keratocunjunctivitis Sicca (KCS) or dry eye as it is commonly known, is a condition found in humans and animals where the eyes do not produce enough tears or moisture for the eyeballs to stay moist and shiny.

Which animals are prone to dry eye?

The condition is common in dogs and rare in cats. Cats who do suffer from the condition tend to show fewer symptoms of eye problems than dogs. Certain dog breeds are predisposed which include Cocker Spaniels, Bulldogs, West Highland White Terriers, Lhasa Apsos and Shih Tzus.

What are the symptoms of dry eye?

The symptoms associated with the condition can vary and are not necessarily very specific. This is why the owner of a pet with dry eye will realise there is something wrong with the dog’s eyes, but they cannot exactly describe what it is. The typical symptoms which one may notice vary and may include a combination of redness and swelling up of the inside of the eyelids (called chemosis), redness of the sclera (the white part of the eye next to the front “see through” (cornea) part of the eye), a discharge in the corner of the eyes, eyelids which are half open or sometimes closed tightly (blepharospasm), the third eyelids starting to move over the eyeball from the inside corner of the eye. Humans with this condition will tell you that it feels like there is sand in their eyes. One can imagine that if there is not sufficient moisture or tears to lubricate the eyeballs that the movement of the eyelids over the eyeball becomes strained every time the animal blinks. In bad cases which have been going for a while, the dryness on the eyeball can cause ulcers to start forming on the cornea with tiny blood vessels starting to appear on the shiny “see through” front part of the eyeball, the cornea. In severe cases, dry eye can lead to loss of vision and partial blindness.

Causes of and risk factors for dry eye

There are a wide range of reasons, conditions and external causes which can lead to dry eye.

Immunologic – Diseases, where the immunity of the animal is compromised or excessively challenged in one way or another, can lead to dry eye. One example is Atopic Dermatitis. This is an allergic skin condition often brought on by the inhalation of allergens like pollens (similar to hay fever in humans), which causes overall itching and scratching with areas of the skin being irritated and red and inflamed.

Congenital – A condition an animal is born with, with certain breeds like Pugs and Yorkshire Terriers more commonly affected.

Neurogenic – occasionally seen after trauma to the face like bite wounds or a car accident where the nerves supplying the tear gland or lacrimal gland are damaged.

Drug or procedure induced – Atropine which is a drug sometimes used to expand the iris so a proper eye exam of the back of the eye (the retina) can be performed will sometimes lead to a transient dry eye. In time this should clear up with no medication required. The same thing can happen when an animal is given a general anaesthetic (GA) and the vet forgets to put an ointment in the eye to cover the cornea, whilst they are doing a medical or surgical procedure. Most people do not realise that animals who are under general anaesthesia sleep with their eyes open. If dry eye happens because of a GA, it will usually clear up by itself a few days later.

Drug toxicity – One group of antibiotics called potentiated sulphonamides have been known to

cause transient or permanent dry eye.

Iatrogenic – Iatrogenic refers to an illness which is brought on by human intervention, typically a medical examination or treatment. The most common cause in dogs will be the removal of the third eyelid or membrana nictitans. There is a condition where this third eyelid starts moving over the eye and only in very exceptional circumstances should this third eyelid ever be removed.

Radiotherapy – Cancer of the eyelids is common in animals with white skin or low pigment in their skin. The treatment of this cancer may require radiotherapy where the beam needs to be aimed at the eyelids with the result that the eye itself is being radiated as well and this can lead to dry eye.

Chronic conjunctivitis – An inflammation with redness and swelling of the eyelids. This condition is more common in cats who suffer from chronic herpes or chlamydia infection.

Can dry eye be confused with other conditions of the eye or the eyelids?

Yes indeed. Dry eye can often be confused with bacterial conjunctivitis. The reason for this is that dry eye will often lead to a situation where there is a secondary overgrowth of bacteria because of the compromised situation of the eye and eyelids. The secret to differentiate lies in the diagnosis which is discussed below.

How is dry eye diagnosed?

Dry eye is diagnosed with the Schirmer tear test. The Schirmer tear test is a simple procedure where a small piece of special absorbable paper is bent over on the one side and hooked on to the lower eyelid of the animal. The rate at which the paper gets wet and the moisture moves down on the piece of paper determines whether enough tears are formed to keep the eye wet. Usually, the paper needs to get wet at the rate of 14 mm per minute. If this does not happen and the paper only gets wet too for instance 5 mm within a minute, it confirms a diagnosis of dry eye.

Other diagnostic tests which the vet may want to perform are fluorescein staining where a bright orange fluid is dropped onto the eyeball. If there is an ulcer on the cornea (which often happens with dry eye) the colour will turn a bright green. If an ultraviolet light is shown onto it, it will turn even brighter and “fluoresce”. The vet may want to take a swab of the eye to do a culture and antibiogram in cases where treatment seems to be unsuccessful. The vet may also want to do a cytobrush test where a tiny “roller brush” is rolled onto the inside of the eyelids, smeared onto a microscope slide, and examined under a microscope. The diagnostic tests done will depend on the particular circumstances of each individual animal suspected to be suffering from dry eye.

How is dry eye treated?

Animals with a confirmed diagnosis of dry eye are usually treated as outpatients. The eyes have to be cleaned before the medication is administered. Owners are usually instructed to keep the eyes and the area around the eyes as clean as possible on an ongoing basis. This is usually done with wiping the eyelids with cotton wool or cloth moistened with lukewarm water or a saline solution. If the animal seems to be developing more pain as the treatment goes on, it is important to get such an animal back to the vet as soon as possible because animals with dry eye are predisposed to severe corneal ulceration if not attended to. In previous decades, before more modern and effective medication was available to treat dry eye a surgical procedure was done were the parotid duct, a small duct which transports saliva from the salivary glands to the back of the mouth, was surgically redirected to the corner of the eye. For lack of anything else this procedure did help to some degree but the saliva tended to be irritating to the cornea and some animals were always uncomfortable after surgery. Fortunately, there are great and effective drugs available to treat this condition today and the two most commonly used medications which stimulate the eye to produce tears are Cyclosporin and Tacrolimus. The vet will assist you in choosing the right option for your pet.

Prognosis for dry eye

Depending on the cause of dry eye, the outcome of treatment is usually very positive these days with the drugs available to help stimulate tear production for the eye. If there are no other conditions like ulceration of the eye, complicating the treatment, animals with dry eye can live good quality lives until they die but will most likely require life long treatment and regular veterinary checkups.

If you are not sure if your dog who seems to have an eye problem has dry eye, bring him or her to the vet for a checkup and have the correct diagnosis made and correct treatment recommended.

My dog has what looks like a red cherry stuck in the corner of its eye

Introduction to cherry eye

A cherry eye is a non-life-threatening condition that occurs in dogs, and less often in some cat breeds. It is an extremely descriptive term, as one can see an oval, bright red swelling in the inside corner of an affected dog’s or cat’s eye, resembling a cherry. As a pet owner one can easily become quite alarmed by seeing this, but fortunately, it only causes slight irritation to the dog initially and you will have time to attend to it and take your animal to the vet before the condition gets out of hand. It is never a good idea to just leave it be. The condition tends to occur more commonly in younger dogs and cats, usually between the ages of 2 and 6 years.

How does it happen that an animal develops a cherry eye?

A cherry eye is in actual fact a protrusion (or bulging out) of the gland of what is colloquially called the third eyelid. Dogs and cats have three eyelids, the top and bottom lids that close up and down over the eyeball as in humans, and then a third eyelid, otherwise called the nictitating membrane underneath the upper and lower eyelids. If you press on the eyeball through the upper eyelid, you will notice the third eyelid moving across the ball of the eye from the inside corner of the eye towards the outside corner of the eye. This eyelid contains a gland that produces up to 30% of the tear production of the eye. The third eyelid provides extra protection to the animal’s eye and keeps the eye moist. The gland in the nictitating membrane is anchored to the corner of the eye by a connective tissue band. For reasons unknown, this connective tissue starts to weaken and the gland slips out of its pocket. If this happens, the gland is exposed to sun, wind, dust, and trauma from the outside. The gland becomes red and swollen, and eventually painful, due to inflammation. One or both eyes may be affected at the same time. The most common breeds affected by this condition are Beagles, Bulldogs, Spaniels, Shih Tzus, Pekingese, and other brachiocephalic (flat-faced) breeds. The condition is rare in cats but Burmese and Persians seem to have a higher incidence of cherry eye.

Other clinical signs associated with cherry eye.

You will quickly notice the red swelling in the corner of your animal’s eye. Other signs that you might notice are a mucoid discharge from the eye and/or redness in the tissue surrounding the eye, called conjunctivitis. Your pet might also show you he/she is experiencing discomfort by pawing at the eye or rubbing his/her face against objects. This can cause even more trauma to the exposed gland.

Course of action with cherry eye

Due to the fact that some dogs don’t seem phased by the popped out gland, some owners might opt to leave it like that. Not treating the gland may however cause more serious problems to the affected eye in years to come. As more damage is inflicted onto the popped out gland, the amount and quality of tear film that protects the eye will decrease causing chronic inflammation and irritation to the eye. The best would be to get treatment of the infected cornea eye as soon as possible. The vet will examine the eye closely and will usually recommend replacing the gland surgically. The vet may stain the cornea with a fluorescein stain to check for ulcers on the eye itself that might have occurred during protrusion of the gland. A few decades ago, it was common practice to remove the gland surgically when it protruded. This is not the practice any longer because by removing a gland that produces tears, the affected eye can dry out causing a condition called keratoconjunctivitis sicca, or more commonly referred to as ‘dry eye’. It is therefore no longer recommended to remove the gland surgically, unless the gland is so traumatised that it will lose its function in any case. Replacing the gland into its original position is usually done under general anaesthesia by anchoring the gland in its pocket with suture material. For an experienced veterinary surgeon it is a relatively easy surgical procedure to perform. The most common complication is a re-occurrence of the cherry eye and trauma to the cornea by suture. If the condition re-occurs it certainly does not mean that the vet did a hopeless job. Between 5 and 20% of dogs have a recurrence of the condition after the surgery. The reason is that the gland can protrude and prolapse to the other side where the sutures were not placed. If it happens the procedure just has to be repeated. There is no way of predicting whether your pet will be one of the unlucky ones where the condition recurs after the initial surgery.

Conclusion

It is not clear why the connective tissue of the third eyelid housing the tear gland weakens causing a cherry eye other than that there seems to be hereditary component. It is therefore not recommended to breed with affected dogs. Taking your dog to be examined by the vet as soon as you see the signs of cherry eye, can save you a whole lot of problems with your pet’s eyes later in his/her life, and even save his or her eyesight.

My dog’s nose seems to be all clogged up and hard and he is not well at all

Following recent outbreaks of Distemper (Hondesiekte in Afrikaans) in Kwa Zulu Natal and Gauteng, it is important to have an understanding of this disease which is fatal in half of all cases of dogs that contract the disease.

What causes Distemper?

Distemper is a virus disease caused by the Canine Distemper Virus or CDV. This virus is a morbillivirus in the Paramyxoviridae family which is a virus group that affects humans, vertebrates and birds. This specific virus is not transmissible to humans but specifically targets dogs hence the name “Canine” Distemper Virus. The virus is closely related to measles virus in humans, and also to rinderpest virus in cattle, which at the beginning of the previous century almost killed the entire cattle population of Southern Africa. It’s a nasty virus.

What are the symptoms of Distemper?

The virus attacks mainly the respiratory system (from the nose right into the lungs), the gastro-intestinal system (from the mouth, through the stomach into the small and large intestines) and the central nervous system (mainly the brain). This means that the symptoms associated with the disease will be related to problems with these three main systems. In acute to subacute infections the dog will usually develop a fever within a day or two from being infected. The dog will go off its food and become weak and lethargic

Respiratory system symptoms may include a clogged up nose typically with mucous or slime that becomes hard, and hardening of the nose itself. This is a very telling symptom of Distemper but is by no means the only, or most typical, presentation of the disease. A dog with distemper may have a perfectly normal nose and still have the disease. Many times there will also be a discharge in the corners of the eyes. Other respiratory symptoms include coughing, sneezing and difficult breathing if the virus attacks the lungs.

If the gastrointestinal systems is affected you may see vomiting and/or diarrhoea.

If the central nervous system is involved you may have muscle tremors, a dog which seems disorientated and walks around as if they are drunk (ataxia), hind limbs which are dragged or seem lazy (paresis), a dog which cannot get up or falls down when they do get up (paralysis), and even seizures. Other symptoms which are not immediately visible and which only the vet may be able to pick up are lesions on the retina at the back of the eye, or an inflammation in the front of the eye called anterior uveitis. Hardening of the footpads (hyperkeratosis) was previously quite common because of the strains of virus involved, but seem to be less common these days.

How is Distemper diagnosed?

There are several blood tests which can be done by the vet, but it is a difficult disease to diagnose because unlike a disease like biliary or tick fever in dogs where you can see the parasite in the blood with a bloodsmear, in Distemper, as with all other virus diseases, you cannot see the virus as it is simply too small. The trouble with the blood tests are that they are often not conclusive. The reason for this is that some of the tests, test if the dog is building up antibodies (“soldier”) against the virus. However a dog that may previously have been vaccinated may show antibodies and not have the disease. Sometimes the dog may die acutely before the body was able to produce neutralising antibodies, so in that case the test may be negative, yet the dog still had the disease.

Another type of blood test where the white and red blood cells are counted and where the white cells are less than usual, called lymphopenia, may give an indication that the dog has a virus disease but it will not tell which virus the dog has.

If the dog has central nervous system symptoms, the fluid around the brain and spine called Cerebro Spinal Fluid (CSF) may contain antibodies but once again it may not be 100% diagnostic. There are other tests which can be run on the CSF (cell or protein content) which may be indicative, but does not conclusively confirm that the dog has Distemper.

There are a number of other diseases which can present with similar symptoms which the vet will have to rule out. On the respiratory side there is Kennel Cough or other upper respiratory tract infections. On the intestinal side there is Parvovirus and Coronavirus, parasitism like worms or Giardia, bacterial infections, toxin ingestion or inflammatory bowel disease. On the neurological side there is granulomatous meningoencephalitis, protozoal encephalitis (toxoplasmosis, neosporosis, babesia), cryptococcus or other infections (meningitis, Ehrlichiosis), pug dog encephalitis and lead or other poisoning.

Clearly Distemper is not a simple disease to diagnose and the vet will often have to rely on the age of the dog, its history, the results of the clinical tests and the appearance of the clinical symptoms, to make a diagnosis of Distemper.

How is Distemper transferred?

The virus is typically inhaled through the air from other sick dogs and also from physical contact with infected animals. The virus can survive for a period of time in the environment and if a dog which carries the virus sniffed around or spent time in a certain environment, it will leave tiny, tiny droplets (aerosol) which contain the virus in that area, which can then infect other dogs. A dog which is infected will inhale or ingest the virus and the virus will quickly spread through the mucous membranes to the local lymphnodes (these are like the remote “army bases” of the body which has to protect the body against invasions) where it will multiply and within one week the whole body will be infected.

How is Distemper treated?

Vets have over the years tried antiviral drugs of which there are very few anyway, and none have been effective. As with almost all virus diseases one has to support the body in its own fight against the virus because it is only once the body has been successful to produce antibodies (the “soldier cells” which kill the “terrorist” or virus), that the dog will be able to overcome the disease. Often, when the body is attacked by viruses and the immune system is fighting hard to overcome the infection, bacteria will cause a secondary infection and make the whole situation worse. Therefore antibiotics are often administered even though it will do nothing against the virus, but at least it will help the body fight off opportunistic bacterial infections and help the body to overcome the disease. Other treatment depends largely on which systems are affected and to what extent. The vet will typically give symptomatic treatment, for example if the dog has seizures, the vet may administer a drug to help contain the seizures and make them less violent. Certain drugs should not be given and it is important to consult with the vet in case you think your dog may suffer from Distemper.

Can Distemper spread to humans or cats?

In the past it was suspected that the Canine Distemper Virus can cause Multiple Sclerosis in humans. However this has been proven NOT to be the case and as far as we know the disease cannot spread from dogs to humans. Similarly, as far as we know, this disease cannot be transferred to domestic cats.

What is the prognosis should my dog contract Distemper?

Unfortunately the prognosis is not good and the mortality rate is 50%. It will be very difficult for the vet to tell whether your dog will fall in the 50% that will survive or the 50% that will not make it. The vet will have to assess the extent and severity of the clinical symptoms and the progression of the disease and based on that, will advise you whether treatment has any chance of success or not. An important thing to remember is that even though the disease may not appear to be very far advanced when you first present your dog to the vet, and there seems to be early good response to treatment, like the clogging of the nose and the discharge in the eyes clearing up, the dog may still develop fatal central nervous system signs later on. It is important to understand that the vet has no control over which way the disease may go and will do his or her best with your animal’s best interest at heart, when recommending treatment or not.

Can Distemper be prevented?

A resounding yes! Vaccination has been hugely effective in almost eradicating this disease and all dogs should be vaccinated, preferably yearly at the same time as their annual health exam. Your vet will give you more specific advice related to the area you live in and the risk factors involved and should the vet think that annual vaccination is not necessary, the vet will advise you accordingly.

Puppies and old dogs are more commonly affected and all puppies should go through an initial vaccination program from 6 weeks onwards to provide protection. Puppies born from mothers who were vaccinated and had antibodies will get this protection from the initial milk or colostrum from the mother in the first few days after birth. The protection provided through the mother’s milk will start waning after six weeks and this is why vets normally start vaccinating at this time, and repeating the vaccination three or four times with booster vaccinations with monthly intervals and then yearly thereafter.

What do I do if I suspect my dog to have Distemper?

Get them to the vet as soon as you can. Home remedies or treatment is unlikely to give your dog a fighting chance. Proper supportive and secondary infection treatment remains the mainstay of treatment.

Most importantly, have your dog vaccinated. Prevention is always better than cure!